Assessing And Managing Risk In Getting It Right For Every .
Assessing and Managing Risk in Getting it right for every childJane Aldgate and Wendy RoseGetting it right for every child team,Children Young People and Social Care,Scottish GovernmentIntroductionThe purpose of this paper is to provide a discussion of risk assessment and risk managementin the context of Getting it right for every child. The first part of the paper looks at theimportance of understanding needs and risks within a framework of a child’s whole world andwell-being. The next part of this paper looks at the context of risk for children in Scotland. Itthen draws on a consensus from the literature to give an overview of the approaches mostcommonly used by different agencies for the assessment of risk in relation to children. Itselects approaches that seem most relevant to working with risks to children’s well-beingwithin the Getting it right for every child framework and indicates how these might be appliedin practice. The paper ends with an outline of an approach to risk assessment andmanagement within the Getting it right for every child practice model.Taking a more inclusive approachThe aim of the Scottish Government is to promote children’s well-being so that all childrenand young people can reach their full potential in adulthood and become successfullearners, confident individuals, effective contributors and responsible citizens. Toachieve their well-becoming in the future, children’s well-being is important at every stage ofchildhood. Every child needs to be healthy, achieving, nurtured, active, respected andresponsible, and, above all, safe. These are the eight indicators of well-being which areused for the purposes of identifying concerns, assessment and planning in the Getting it rightfor every child practice model which we will describe later.Many children may have temporary difficulties in one or more aspects of their well-being,which will affect how they progress but if these are dealt with quickly and appropriately,children will continue to flourish. Some may face more serious risks from vulnerabilitieswithin themselves, such as health problems or genetic conditions that affect their learning.Some are placed at risk by those close to them, such at children at risk of neglect or abuse.Children may also become victims of bullying, other violence from peers or discrimination.There are also children who place themselves at risk through their behaviour. This willVersion 1.2, November 20081
include children who present a risk of serious harm to themselves and others. The lifeopportunities of some children are affected by living in continuing poverty and dangerouscommunities (Scottish Government 2008a). In all these cases, children will have complexneeds. Many of these children, who are not meeting their Well-being Indicators, will have acomplex mix of risks and needs. Indeed, we would ague that risks and needs are two sides ofthe same coin. If a child is at risk in some way, that child will have needs related to their wellbeing. The more complex and interrelated the risks, the more likely that children’s well-beingwill be affected on several fronts.In spite of the impact of multiple risks, writers in child development take a more optimisticview of children’s resilience and ability to recover from negative experiences (Schaffer 1998;Aldgate et al. 2006). Cicchetti et al., for example, go so far as to suggest that most childrenmaintain the ability to’ show some resilience strivings in the presence of serious and chronicadversity’ (Cicchetti et al. 1993, p. 642).It is important, therefore, to work in an integrated way with children, one which recognises thebalance between positive and negative influences. Inner vulnerabilities may be counteractedby resilience and adversity may be counteracted by protective factors (Daniel and Wassell2002). This way of working will apply to all practitioners from different disciplines acrossdifferent agencies. It also influences how parents can support their children. If this morebalanced, inclusive approach is not taken to working with children, as Graybeal and Konrad(2008) point out, there are dangers of practitioners from any agency polarising their way ofworking into either ‘risk assessment’ or ‘strengths based approaches’, whereas what may bemost in children’s interests is to develop inter-agency approaches that look at the wholepicture of the child’s life. Graybeal and Konrad believe that ‘problems and strengths are interrelated and inextricable from one another, and are discovered through dialogue’ (Graybealand Konrad 2008, p.185). They emphasise the importance of working collaboratively withchildren and families. Furthermore, it is not helpful simply to identify a risk without takingaction to eliminate or, more commonly, manage that risk. This approach is central to theScottish Government’s attitude to assessing risk in relation to offenders:The need for information and assessment, whilst crucial to the management process, does not negate theneed for action (Scottish Government 2008b, p. 37).This way of thinking is fundamental to Getting it right for every child. Dialogue betweenchildren and families and practitioners within and between agencies is the foundation forVersion 1.2, November 20082
ensuring children and families are fully included in discussing problems and possiblesolutions, and that agencies share information appropriately as needed. It also underpins anyintegrated approach to providing help. Traditionally, agencies have seen helping a child onlyin terms of the part of the child’s life that is the concern or responsibility of their agency.Getting it right for every child asks all practitioners to think about a child’s problems not onlyfrom their agency’s perspective but also to see any risks and needs in the context of thewhole of a child’s life. Getting it right for every child is founded on 10 core components whichcan be applied in any setting and in any circumstance (Scottish Government 2008c). Theyprovide the core of the Getting it right for every child approach in practice and provide abenchmark from which practitioners may apply the approach to their areas of work. Theyalso inform a range of other policy developments and initiatives, some explored in more detaillater on, such as Hall 4 (Scottish Executive 2005a) and A Curriculum for Excellence (ScottishExecutive 2006a), and others which have a considerable impact, such as the Early YearsFramework with its emphasis on early intervention (Scottish Government 2008d).Core Components:1. A focus on improving outcomes for children, young people and their families based ona shared understanding of well-being2. A common approach to gaining consent and to sharing information where appropriate3. An integral role for children, young people and their families in assessment, planningand intervention4. A co-ordinated and unified approach to identifying concerns, assessing needs,agreeing actions and outcomes, based on the Well-being Indicators5. Streamlined planning, assessment and decision-making processes that lead to theright help at the right time for children6. Consistent high standards of co-operation, joint working and communication wheremore than one agency needs to be involved, locally and across Scotland7. A lead professional to co-ordinate and monitor multi-agency activity where necessary8. Maximising the skilled workforce within universal services to address concerns at theearliest possible time9. A confident and competent workforce across all services for children, young peopleand their families10. The capacity to share demographic, assessment and planning informationelectronically within and across agency boundaries through the national eCareprogramme where appropriate(Scottish Government 2008c, p. 14).Version 1.2, November 20083
Getting it right for every child has an integrated, common approach to gathering informationabout a child’s well-being. It uses three tools: the Well-being Indicators, the My WorldTriangle and the Resilience Matrix. The construct of well-being is central to understandinghow children develop. The My World Triangle helps practitioners gather relevant informationinto a mental map of the strengths and pressures affecting a child and family. The triangle isdeliberately presented from the child’s perspective to reinforce the Getting it right for everychild principle that children at the centre of any of the activities of practitioners. The constructof resilience is embedded in the language of many agencies and is linked with understandinghow risks may be overcome or managed. The ecological approach in these three tools iswell-grounded in child development theory about the interactions and transactions that takeplace within and between different parts of a child’s world (see, for example, Daniel et al.1999, Rose and Aldgate 2000; Aldgate et al. 2006). Later in this paper, we discuss how theWell-being Indicators, the My World Triangle, and the Resilience Matrix are used in theassessment of needs and risks for any child about whom there are concerns.Problems in defining riskThe assessment of risk of both adults and children has posed some difficulties in findingcommon definitions. In her review of the international literature on risk assessment for theScottish Government, Barry (2007) suggests there is no clear definition of risk, and littleconsistency in defining high, medium and low risks. Low risks are often seen as a matter ofprofessional judgement. Barry goes on to suggest that risk factors can be static or dynamic.Static risk factors, such as age, sex, offence history health or education record, do notchange. Dynamic factors, by contrast, can change over time and are both ‘variable andoutwith the control of the individual’ (Barry 2007, p. 5). These include income andemployment patterns, changes of school, as well as changes through choice, such as druguse or vandalism. Barry comments that a combination of static and dynamic factors is morelikely to be effective in predicting risk rather than static factors alone.Risk may also be influenced by the approach of different disciplines. Carson (1994), quotedin Cleaver et al. (1998), for example, draws a comparison between social work, which tendsto focus on risk as applied to harm and other areas, where risk analysis also includesbenefits or positive factors that might result from taking risks. Such an approach is familiarterritory for the medical profession in weighing the merits of a particular intervention. AsCleaver et al. (1998) comment, discussion of risk outwith child protection:Version 1.2, November 20084
always assumes that there is a choice between taking the risk and not taking the risk, and that risks by theirnature can be put off until a more favourable time. In social work risk taking, however, there are usually noharm free options, even a ‘do nothing’ option has dangers’ (Cleaver et al.1998, p.11).Health and assessing riskIn the area of children’s health, Health for All Children 4 (Scottish Executive 2005a) which iscommonly known as Hall 4, locates the initial identification of risk within the universal service.It sets out ‘a core programme of health checks, screening activity and health promotion for allchildren from birth to five years’ (Scottish Executive 2005a, p. 33). Where children areidentified as being in need and/or at risk, there can be additional support which may be wideranging. This may include multi-agency work, which acknowledges the interface betweenhealth and social issues. Hall 4 advocates health professionals take an holistic view of achild. There is recognition, for example, that schools can play a big part in minimising therisks to children’s health by promoting active and healthy lifestyles, including healthy eatingand sport. Often parents and carers will pick up health issues but health practitioners willoften be the first professionals to pick up concerns about children’s safety and nurture athome. Such early interventions, including an emphasis on promoting good care givingbehaviour between parents and children, can also be the most effective way to preventdeveloping mental health problems in children.The implementation of Hall 4 includes children’s mental health. It links with the ScottishExecutive’s Mental Health Framework for Children and Young People (Scottish Executive2005b). The Framework stresses:the importance of considering the child’s global environment, recognising elements which support mentalhealth and wellbeing as well as those factors which may increase the risk of mental health problems,including the potential impact of a parent’s ill health on their child.The Framework promotes a “mainstream” approach to mental health and wellbeing, which equips a range ofhealth and other children’s services professionals with the basic skills to be able to support parents indeveloping a basic understanding of risk and protective factors that may affect their child’s mental health andwellbeing(Scottish Executive 2005a, p. 23).Education and assessing riskVersion 1.2, November 20085
Education policy also recognises the importance of taking a whole child approach from withineducation. A Curriculum for Excellence recommends that children’s well-being is on theagenda of teachers:Curriculum for Excellence has an important role to play in promoting the health and wellbeing of children andyoung people and all of those in educational communities to which they belong. Learning through health andwellbeing promotes confidence, independent thinking and positive attitudes and dispositions. Because ofthis, it is the responsibility of every teacher to contribute to learning and development in this area (ScottishExecutive 2006a, p.10).The links between children’s development, well-being and the handling of transitions in theireducational careers are also recognised:The transition from early years to primary school, primary school to secondary school, and from secondaryschool to employment or further education or training, have been identified as vulnerable stages ofdevelopment for children and young people. Transitions between geographical and agency areas can alsobe vulnerable points (Scottish Executive 2005a, p. 42).The importance of transitions is stressed in the Education (Additional Support for Learning)(Scotland) Act 2004 which makes provision ‘to strengthen future needs planningarrangements for those young people with additional support needs, who need extra help, toensure a successful transition to post-school life’ (Scottish Executive 2005a, p. 42).Education also has to take account of children’s safety in different ways. Every school hasprotocols for working in partnership with social work in child protection. Teachers also have tobe mindful of assessing the risks to children’s physical safety if they take children out ofschool on excursions, as well as attending to Health and Safety procedures to minimise riskswithin the school building.Social work and assessing riskThe Children (Scotland) Act 1995 places a duty on local authorities to safeguard and activelypromote the welfare of children in need in their area by providing services to them and/ortheir families. Within local authority services, social work has an important part to play inassessing and providing services for children in need. Changing Lives (Scottish Executive2006b) points out that social workers are particularly well equipped to be the leadprofessional in collaborative work in many circumstances including where:Version 1.2, November 20086
the child or adult is at risk of serious harm from others or themselves and requires skilled riskassessment and protection; the child or adult is likely to put others at risk or harm, distress or loss and a response needs to takeaccount of the individual’s interests and well-being of others; the child’s or adult’s circumstances, including their health, finances, living conditions or socialsituation, are likely to cause them or others serious harm, social exclusion or reduction of lifechances; the situation requires assessment of, and intervention in unpredictable emotional, psychological,intra-family or social factors and responses; the circumstances are such that there are significant risks in both intervening and not intervening,when a fine judgement is required (Scottish Executive 2006b, p. 29).Social workers’ unique contribution is spelt out through the duties laid on them by legislation.Social workers are likely to play a prominent role when children need protecting. They willhave the complex task of assessing both risk and need at all stages of working with childrenand families in these circumstances. This will include assessing the impact on children ofadult family members’ substance misuse, domestic abuse or mental health issues. Theresponsibilities of social work departments and indeed of the local authority as a whole areparticularly clear and important where the local authority has assumed the role of ‘corporateparent’ (see Scottish Government 2008e). There are special considerations of needs andrisks in relation to kinship care, foster care, residential care and adoption.Police and assessing riskThe police in Scotland encounter children in a wide and varied set of circumstances. Theprimary duties of the police are to ensure that immediate risks to a child’s safety are identifiedand action taken which is necessary to safeguard that child. The Children (Scotland) Act1995 s.61(5) provides powers to constables to remove a child in emergency circumstanceswhen there is immediate risk of significant harm, with less urgent though equally concerningsituations catered for through the application process for Child Protection Orders. Liaisonwith partners in social work, health and education is crucial to the assessment made on adynamic basis using collective, evidence informed professional judgement. This is consistentwith Getting it right for every child processes for identifying and acting upon concerns. Wherethere is such urgency that consultation is impossible action would be taken on a singleagency basis.Version 1.2, November 20087
Where a child is involved in an incident as a victim, witness or suspect, assessment of riskwill run in parallel with the criminal investigation to establish circumstances amounting to acrime and identify the offender. Throughout an investigation, the consideration of risk to thechild’s safety will remain paramount. Liaison with partners in assessing risk and actionsrequired to meet the child’s needs will be key. This includes contact with key personnel in theuniversal services, such as the named person in Highland, and with the lead professionalwhere one has been appointed.It is not the role of the police to carry out complex and detailed assessment of a child’sneeds. The police can, however, contribute to the holistic package of information required forthe assessment of, and planning for, a child’s needs. Training for police officers includes‘child protection awareness’ at all stages of their careers. Operational staff are encouraged toidentify situations of concern and act appropriately, recording and flagging their concerns.Specialised units/points of contact within police forces have the responsibility of liaising withpartner agencies where concerns are identified. Where joint police and social work interviewsare necessary, good practice guidance is available (see Scottish Executive 2003a). AsGetting it right for every child is embedded in practice, the police will be encouraged to usethe Well-being Indicators against which they will be able to log their concerns. Trialling of thisapproach in the Highland Pathfinder is proving to be helpful to joint working.Youth justice and assessing riskIn youth justice, Barry (2007) suggests that the experience of crime is actually far less thanthe fear of it. The chances of engaging in anti-social behaviour rise with the presence ofmultiple risk factors such as poor parental superv
Assessing and Managing Risk in Getting it right for every child Jane Aldgate and Wendy Rose Getting it right for every child team, Children Young People and Social Care, Scottish Government. Introduction . The purpose of this paper is to provide a discussion of risk assessment and risk management in the context of . Getting it right for every .
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